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Abdominal Emergencies Requiring a Multidisciplinary Approach

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Primary Management in General, Vascular and Thoracic Surgery


Aortoenteric fistula is an emergent disease with high risk of mortality. An abnormal communication between the aorta and intestine occurs more frequently with the duodenum and usually is related to an abdominal aortic aneurysm or secondary to aortic surgery. A delay in diagnosis could be fatal for the patient. For the diagnosis, a CT scan is the first choice meanwhile esophagogastroduodenoscopy is performed in an emergency setting just in hemodynamically stable patients.

Mesenteric ischemia is a syndrome caused by inadequate blood flow through visceral vessels: it can be acute or chronic. In an acute setting it is considered an emergent disease that should be rapidly treated with open or endovascular approach to reduce the risk of bowel gangrene.

Both these pathologies require a multidisciplinary approach by vascular and general surgeons for vascular reconstruction and treatment of bowel defects; also anesthesiologists and intensivists must be prepared to resuscitate aggressively in the face of life-threatening exsanguination and postoperative management.

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  1. Cooper A. Lectures on principles and practice of surgery with additional notes and cases by F. Tyrrell. 5th ed. Philadelphia, PA: Haswell, Barrington, & Haswell; 1839.

    Google Scholar 

  2. Hallett JW Jr, Marshall DM, Petterson TM, Gray DT, Bower TC, Cherry KJ Jr, Gloviczki P, Pairolero PC. Graft-related complications after abdominal aortic aneurysm repair: reassurance from a 36-year population-based experience. J Vasc Surg. 1997;25(2):277–84.; discussion 285–6.

  3. O'Hara PJ, Hertzer NR, Beven EG, Krajewski LP. Surgical management of infected abdominal aortic grafts: review of a 25-year experience. J Vasc Surg. 1986;3(5):725–31.

    Article  CAS  Google Scholar 

  4. Lemos DW, Raffetto JD, Moore TC, Menzoian JO. Primary aortoduodenal fistula: a case report and review of the liter- ature. J Vasc Surg. 2003;37:686–9.

    Article  Google Scholar 

  5. Bergqvist D, Björck M. Secondary arterioenteric fistulation - a systematic literature analysis. Eur J Vasc Endovasc Surg. 2009;37:31–42.

    Article  CAS  Google Scholar 

  6. Bunt TJ. Synthetic vascular grafts infections. II: graft enteric erosion and graft enteric fistulas. Surgery. 1983;94:1.

    CAS  Google Scholar 

  7. Raman SP, Kamaya A, Federle M, et al. Aortoenteric fistulas: spectrum of CT findings. Abdom Imaging. 2013;38:367–75.

    Article  Google Scholar 

  8. Chung J. Management of aortoenteric fistula. Adv Surg. 2018;52(1):155–77.

    Article  Google Scholar 

  9. Vokurka J, Olejnik J, Jedlicka V, et al. Acute mesenteric ischemia. Hepato-Gastroenterology. 2008;55:1349–52.

    Google Scholar 

  10. Tallarita T, Oderich GS, Macedo TA, et al. Reinterventions for stent restenosis in patients treated for atherosclerotic mesenteric artery disease. J Vasc Surg. 2011;54:1422–9.e1.

    Article  Google Scholar 

  11. Poole JW, Sammartano RJ, Boley SJ. Hemodynamic basis of the pain of chronic mesenteric ischemia. Am J Surg. 1987;153:171–6.

    Article  CAS  Google Scholar 

  12. Schoots IG, Koffeman GI, Legemate DA, et al. Systematic review of survival after acute mesenteric ischaemia according to disease etiology. Br J Surg. 2004;91:17–27.

    Article  CAS  Google Scholar 

  13. Moneta GL, Lee RW, Yeager RA, et al. Mesenteric duplex scanning: a blinded prospective study. J Vasc Surg. 1993;17:79–84. discussion 5–6.

    Article  CAS  Google Scholar 

  14. Tallarita T, Oderich G. Acute mesenteric vascular disease. In: Settembrini P, Minerva Medica, editors. Vascular surgery: how when why Ed; 2017.

    Google Scholar 

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Mazzari, A., Tomaiuolo, P.M.C., Giordano, A., Meniconi, R.L., Settembrini, A.M. (2022). Abdominal Emergencies Requiring a Multidisciplinary Approach. In: Bissacco, D., Settembrini, A.M., Mazzari, A. (eds) Primary Management in General, Vascular and Thoracic Surgery. Springer, Cham.

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